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Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries.
Psychosom Med 2019; 81(7):629-640PM

Abstract

OBJECTIVE

The aim of the study was to evaluate psychiatric symptoms among 1022 persons with various disorders of sex development (DSDs).

METHODS

The study was a European multicenter cross-sectional clinical evaluation in six countries. The mean (SD) age of participants was 32.1 (13.4) years. The cohort consisted of 325 individuals with Turner syndrome, 219 individuals with Klinefelter syndrome (KS), female individuals with various XY-DSD conditions (107 with and 67 without androgenization), 87 male individuals with XY-DSD conditions, and 221 female individuals with congenital adrenal hyperplasia. The Hospital Anxiety and Depression Scale, the Short Autism Spectrum Quotient, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, and self-reported mental health history were used to assess psychiatric symptoms.

RESULTS

Across the six DSD diagnostic groups, clinical cutoff symptom scores were reached in 19.5% of participants for anxiety, in 7.1% for depression, in 4.1% for attention-deficit/hyperactivity disorder, and in 9.1% for autism. The mean depression and anxiety scores were higher compared with population norms in men with KS and men with XY-DSD. Compared with participants with other DSD conditions, men with KS reported significantly more mental health symptoms. Self-esteem, satisfaction with care, body dissatisfaction, and experiences of shame were associated with psychiatric symptoms in many DSD conditions.

CONCLUSIONS

A substantial minority of adults with DSD, with KS in particular, experience psychiatric morbidity. Across DSD conditions, adults may share feelings of shame. Developing a positive self-esteem and body image may be challenging. Multidisciplinary DSD care that involves specialized mental health support can be of important value.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00006072.

Authors+Show Affiliations

From the Department of Child and Adolescent Psychiatry (de Vries), Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, the Netherlands; Charité - Universitätsmedizin Berlin (Roehle), Coordinating Center for Clinical Studies, Institute of Biometry and Clinical Epidemiology, Berlin Institute of Health; Klinik fur Kinder- und Jugendmedizin (Marshall, Thyen, Rapp), Universitat zu Lubeck, Germany; Department of Clinical Neuroscience (Frisén), Karolinska Institutet; Child and Adolescent Psychiatry Research Center (Frisén), Stockholm, Sweden; Department of Medical Psychology (van de Grift, Kreukels, Cohen-Kettenis), Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers; Department of Plastic (van de Grift), Reconstructive and Hand Surgery, Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands; Endocrinologie pediatrique (Bouvattier), Centre de reference des maladies rares du developpement sexuel, Hopital Bicetre, Universite Paris-Sud, Le Kremlin Bicetre, France; Charité - Universitätsmedizin Berlin (Köhler), Klinik fur Padiatrie mit Schwerpunkt Endokrinologie und Diabetologie, Berlin, Germany; and Department of Women's and Children's Health (Nordenström), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31232913

Citation

de Vries, Annelou L C., et al. "Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries." Psychosomatic Medicine, vol. 81, no. 7, 2019, pp. 629-640.
de Vries ALC, Roehle R, Marshall L, et al. Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries. Psychosom Med. 2019;81(7):629-640.
de Vries, A. L. C., Roehle, R., Marshall, L., Frisén, L., van de Grift, T. C., Kreukels, B. P. C., ... Cohen-Kettenis, P. T. (2019). Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries. Psychosomatic Medicine, 81(7), pp. 629-640. doi:10.1097/PSY.0000000000000718.
de Vries ALC, et al. Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries. Psychosom Med. 2019;81(7):629-640. PubMed PMID: 31232913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mental Health of a Large Group of Adults With Disorders of Sex Development in Six European Countries. AU - de Vries,Annelou L C, AU - Roehle,Robert, AU - Marshall,Louise, AU - Frisén,Louise, AU - van de Grift,Tim C, AU - Kreukels,Baudewijntje P C, AU - Bouvattier,Claire, AU - Köhler,Birgit, AU - Thyen,Ute, AU - Nordenström,Anna, AU - Rapp,Marion, AU - Cohen-Kettenis,Peggy T, AU - ,, PY - 2019/6/25/pubmed PY - 2019/6/25/medline PY - 2019/6/25/entrez SP - 629 EP - 640 JF - Psychosomatic medicine JO - Psychosom Med VL - 81 IS - 7 N2 - OBJECTIVE: The aim of the study was to evaluate psychiatric symptoms among 1022 persons with various disorders of sex development (DSDs). METHODS: The study was a European multicenter cross-sectional clinical evaluation in six countries. The mean (SD) age of participants was 32.1 (13.4) years. The cohort consisted of 325 individuals with Turner syndrome, 219 individuals with Klinefelter syndrome (KS), female individuals with various XY-DSD conditions (107 with and 67 without androgenization), 87 male individuals with XY-DSD conditions, and 221 female individuals with congenital adrenal hyperplasia. The Hospital Anxiety and Depression Scale, the Short Autism Spectrum Quotient, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, and self-reported mental health history were used to assess psychiatric symptoms. RESULTS: Across the six DSD diagnostic groups, clinical cutoff symptom scores were reached in 19.5% of participants for anxiety, in 7.1% for depression, in 4.1% for attention-deficit/hyperactivity disorder, and in 9.1% for autism. The mean depression and anxiety scores were higher compared with population norms in men with KS and men with XY-DSD. Compared with participants with other DSD conditions, men with KS reported significantly more mental health symptoms. Self-esteem, satisfaction with care, body dissatisfaction, and experiences of shame were associated with psychiatric symptoms in many DSD conditions. CONCLUSIONS: A substantial minority of adults with DSD, with KS in particular, experience psychiatric morbidity. Across DSD conditions, adults may share feelings of shame. Developing a positive self-esteem and body image may be challenging. Multidisciplinary DSD care that involves specialized mental health support can be of important value. TRIAL REGISTRATION: German Clinical Trials Register DRKS00006072. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/31232913/Mental_Health_of_a_Large_Group_of_Adults_With_Disorders_of_Sex_Development_in_Six_European_Countries L2 - http://dx.doi.org/10.1097/PSY.0000000000000718 DB - PRIME DP - Unbound Medicine ER -